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This case is a great example of asymmetric male gynecomastia. The right sided breast tissue overdevelopment was far more problematic than the left. Utilizing an endoscopic approach, the right side’s breast tissue was removed, the redundant skin was then excised, incisions hidden within the borders of the areola. The left side was managed with liposuction through strategically placed, nearly invisible ports. Along with some diet and exercise, at 6 months the results are already apparent and significant.